Provider Demographics
NPI:1760915078
Name:OAK, ALLEN SI WON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:SI WON
Last Name:OAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SI WON
Other - Middle Name:
Other - Last Name:OAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1720 UNIVERSITY BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1720 UNIVERSITY BLVD STE 500
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-975-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program